Work Package 3

Healthcare workers Delphi Study

Background – The research problem – Aims of the study

Healthcare professionals’ recommendation for vaccination is a major driver for vaccine update. During the COVID19 pandemic, HCP remained an important and trusted source of information about the new COVID19 vaccines (2). Nonetheless, HCP continued to face challenges in dealing with vaccine hesitancy and if anything, these challenges became more difficult to tackle (3).

A recent Cochrane review of 11 studies that summarized evidence on HCP’ perceptions and experiences of communicating vaccine related information to elderly patients before the COVID19 pandemic suggested a wide range of recommendations for improving practice (1). These ranged from practical issues such as having the time to discuss with patients about vaccinations, to addressing knowledge gaps in vaccine safety and enhancing communications skills on a shared decision making. 

This review however addressed the experience of HCP in communicating vaccine related information but did not specifically address the challenges of consultations with vaccine hesitant individuals. Iinformation on the latter is limited but important if the ultimate goal is to improve attitudes towards vaccinations and vaccine acceptability. 

This study aims to:

  1. Assess the knowledge and skills gaps of healthcare professionals in primary care on conducting effective consultations with vaccine hesitant individuals
  2. Identify training priorities within a series of needs and arrive at a consensus on the areas to be included in an educational curriculum on effective consultations on vaccine hesitancy


The Delphi methodology will be adopted. This methodology uses a series of rounds (discussions, questionnaires) to collect opinions (information) from experts on a research topic with the ultimate goal to arrive at a consensus of what the group thinks. Due to time availability, this Delphi study will use three rounds to arrive at consensus of opinions.

Round 1

Round 1 of the study will involve the following steps:

  • Development of a questionnaire for Round 1: the aim of the Round 1 questionnaire is to collect qualitative comments on the “research problem” (knowledge and skills gaps and training needs of HCP to conduct consultations with vaccine hesitant individuals)  from an expert panel and after analysing them, convert them into a quantitative form, the round 2 questionnaire knowledge and skills gaps and training needs of HCP to conduct consultations with vaccine hesitant individuals
  • Formation of a steering group of experts/stakeholders (GPs, Primary care nurses and allied health care professionals, experts in medical/healthcare education, patient groups)
  • Round 1: Group discussion/brainstorming with expert panel using the questionnaire
  • Analysis of Round 1 data: CAT group to review items, remove duplicates and organise the items into different categories to be group them in a questionnaire for Round

Round 2

Round 2 of the study will involve the following steps:

  • Round 2: Health care professionals in primary care working in European countries to be invited to rate the items in questionnaire 2 (developed from Round 1) in terms of their importance to be included in a training curriculum on effective consultations with vaccine hesitant individuals
  • Analysis of Round 2 data: CAT group to perform data analysis of the rating scores from Round 2 

Round 3

  • Expert panel of Round 1 will be invited to review results of Round 2, decide on consensus level for inclusion in the curriculum (e.g. 80% of participants rate as important or very important) and finalise topics to be included in the curriculum

Report writing on Curriculum development

The CAT team prepare report and the outline of a training curriculum that can be disseminated to professional organisations and academia.


  1. Clenton C et al. Healthcare workers’ perceptions and experiences of communicating with older adults about vaccination. Cochrane July 2021
  2. El-Elimat T. Acceptance and attitudes toward COVID-19 vaccines: A cross-sectional study from Jordan. Plos one, April 2021
  3. Adhikari B et al. Vaccine hesitancy in the COVID19 era. The Lancet, July 2021.



  1. Development of grid for Round 1
  2. Formation of expert panel
  3. Round 1 discussion
  4. Analysis of Round 1 results
  5. Development of Round 2 questionnaire
  6. Round 2- dissemination of questionnaire to HCP
  7. Analysis of Round 2 results
  8. Round 3 discussion and finalisation of curriculum items
  9. Preparation of report and outline of curriculum


Led by: Ourania Kolokotroni, Cyprus University of Technology

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